PICC lines (peripherally inserted central catheters)
PICC lines (peripherally inserted central catheters) are used to give someone chemotherapy treatment or other medicines.
This is an animation about having a PICC line (peripherally inserted central catheter).
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The information in this video was correct as of 14 May 2014.
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We hope this information answers your questions. If you have any further questions, you can ask your doctor or nurse at the hospital where you're having your treatment.
A PICC line is a long, thin, flexible tube known as a catheter. It’s put into one of the large veins of the arm, near the bend of the elbow. It’s then threaded into the vein until the tip sits in a large vein just above the heart.
The line is usually sealed with a special cap or bung. This can be attached to a drip or syringe containing your medication. There may be a clamp to keep the line closed when it’s not being used.
Sometimes, it divides into 2 or 3 lines. This allows you to have different treatments at the same time.
What PICC lines are used for
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A PICC can be used to give you treatments such as chemotherapy, blood transfusions, antibiotics, intravenous (IV) fluids and liquid food if you’re not able to eat. It can also be used to take samples of your blood for testing.
This means you won't need to have needles put in every time you have treatment.
You can go home with the PICC line in and it can be left in for weeks or months.
A PICC may be helpful if doctors and nurses find it difficult to get needles into your veins. It’s also helpful if you don't like needles.
How the PICC line is put in
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Your PICC line will be put in by a specialist nurse or doctor in an outpatient department or on a ward. This will be done using a local anaesthetic.
First, the skin in the area is cleaned with antiseptic solution. Then this area is numbed with an anaesthetic cream or injection.
When the skin is completely numb, a needle will be put into the vein. The PICC line is then threaded through the needle, into a large vein that leads to your heart. The needle is removed at the same time. This shouldn't take long and is usually painless. The PICC line will be held in place by a transparent dressing.
You will have a chest x-ray to check that the end of the tube is in the right place.
Possible problems when putting in the PICC line
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If your veins are small, it may be difficult to find a suitable one to put the PICC line into. Your doctor or nurse may use an ultrasound scan to help them find the best vein to use. The ultrasound uses sound waves to produce a picture of the veins in your arm. A small hand-held device is rubbed gently over your arm. This is painless.
It can sometimes be difficult to thread the PICC line up the vein towards the heart. If this happens, it's usually possible to try again using a different vein.
Sometimes, the PICC line seems to go in easily but the x-ray shows it isn't in the right place. If this happens, your nurse or doctor may be able to move it. If this doesn’t work, it will be taken out and replaced.
Caring for your PICC line
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When the PICC line isn't being used, there is a slight risk of it becoming blocked. To stop this from happening, a small amount of fluid is flushed into the line using a syringe. This is usually done once a week. The caps or bungs at the end of the line will need to be changed each week to reduce the risk of infection. The dressing will also need to be changed every week.
It's difficult to do this with one hand, so the nurses at the hospital may do it for you or arrange for a district nurse to visit you at home. They can also teach a relative, partner or friend how to do this.
When you’re at home, it's safe for you to have a shower or bath with your PICC line in. Your nurse can give you waterproof covers to stop the line getting wet.
Possible problems with PICC lines
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It’s possible for an infection to develop inside the line or in the area where it goes into the vein.
Contact your hospital doctor or nurse if you have:
redness, swelling or pain in the area
discoloured fluid coming from the area
a high temperature (fever).
If you get an infection, you will be given antibiotics. If the infection doesn’t get better, the line may be removed.
It’s possible for a blood clot (thrombosis) to form in your vein at the tip of the line. You may be given medication to help prevent this. Contact your hospital doctor or nurse if you notice any swelling, redness or tenderness in the arm, chest area, or up into the neck (on the same side as the PICC line).
If a clot does form, you will be given some medication to dissolve it. Your line may have to be removed.
Air in the PICC line
It’s important not to get any air into your PICC line. Not all PICC lines have clamps. Some lines have caps at the end that stop air from getting into the line. If your PICC line has a clamp, it should always be closed when the line isn't being used. The line must not be left unclamped when the caps aren't in place.
The PICC line may come out
To stop the line coming out by accident, it should always be taped or covered with a dressing. If the dressing holding the PICC line in place comes loose, contact your district or hospital nurse immediately. Then it can be replaced as soon as possible.
Break or cut in the PICC line
It is important that the PICC line is not cut or split. Don’t use scissors near the PICC line. It’s not very common to get a cut or split in the line. If this happens, contact your hospital immediately. The line may need to be removed if it can't be repaired.
How the PICC line is removed
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When you don’t need a PICC line anymore, it will be taken out. A nurse will usually do this for you in an outpatient department. It will be gently pulled out. This is a painless procedure and only takes a few minutes.
This information has been compiled using information from a number of reliable sources, including:
Bishop, et al. Guidelines on the Insertion and Management of Central Venous Access Devices in Adults. International Journal of Laboratory Haematology. 2007.
Dougherty, et al. The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 8th edition. 2011. Wiley - Blackwell
Perry MC. The Chemotherapy Source Book. 4th edition. 2008. Lippincott Williams and Wilkins.
Souhami, Hochhaser. Cancer and its management. 6th edition. 2010. Wiley-Blackwell.
Thank you to Ms Elaine Chapman, Lead Chemotherapy Nurse, who reviewed this edition and all of the people affected by cancer who reviewed what you're reading and have helped our information to grow.
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